CAJ | 학술논문

背景:与传统腹腔镜技术相比,机器人辅助外科特别是达芬奇手术系统可以提供良好的三维成像技术、更好的人体生物工程学设计及更加精细的操作.目的:通过Meta分析评价机器人辅助外科达芬奇手术系统Nissen胃底折叠在治疗胃食管反流性疾病中的安全性及可行性.方法:运用计算机检索Embase、OVID及PubMed等数据库有关达芬奇系统辅助Nissen胃底折叠治疗胃食管反流性疾病的论文.根据数据类型不同,统计方法分别采用倒方差法和 M-H 法,并根据异质性分析结果分别采用随机效应模型和固定效应模型.结果与结论:共纳入5篇文献,累计160例患者.Meta分析结果显示,除术中及术后并发症外,传统腹腔镜组与机器人Nissen胃底折叠组总手术时间、有效手术时间、术后吞咽困难发生率、中转开腹或中转为传统腹腔镜手术率、再手术率、住院时间及住院费用差异均无显著性意义(P>0.05).说明机器人Nissen胃底折叠在治疗胃食管反流行疾病时并不优于传统腹腔镜手术,因此应谨慎选择适应证.
배경:여전통복강경기술상비,궤기인보조외과특별시체분기수술계통가이제공량호적삼유성상기술、경호적인체생물공정학설계급경가정세적조작.목적:통과Meta분석평개궤기인보조외과체분기수술계통Nissen위저절첩재치료위식관반류성질병중적안전성급가행성.방법:운용계산궤검색Embase、OVID급PubMed등수거고유관체분기계통보조Nissen위저절첩치료위식관반류성질병적논문.근거수거류형불동,통계방법분별채용도방차법화 M-H 법,병근거이질성분석결과분별채용수궤효응모형화고정효응모형.결과여결론:공납입5편문헌,루계160례환자.Meta분석결과현시,제술중급술후병발증외,전통복강경조여궤기인Nissen위저절첩조총수술시간、유효수술시간、술후탄인곤난발생솔、중전개복혹중전위전통복강경수술솔、재수술솔、주원시간급주원비용차이균무현저성의의(P>0.05).설명궤기인Nissen위저절첩재치료위식관반류행질병시병불우우전통복강경수술,인차응근신선택괄응증.
BACKGROUND:Compared with conventional laparoscopic techniques, robot-assisted surgery, especial y the Da Vinci Surgical System, can provide a good three-dimensional imaging, better human bioengineering design and more sophisticated operations. OBJECTIVE:To evaluate the efficacy and feasibility of robotic Nissen fundoplication for the treatment of gastroesophageal reflux disease through Meta-analysis. METHODS:A comprehensive search of PubMed database, Embase database and OVID database was performed by computer to determine al published research papers on the comparison of robotic versus conventional laparoscopic Nissen fundoplication for the treatment of gastroesophageal reflux disease. The inverse-variance method and Mantel-Haenszel method were used for the analysis depending on the data type with fixed effect model or random effect model according to the heterogeneity. RESULTS AND CONCLUSION:Five studies met the criteria final y, which included 160 patients. Meta analysis showed that except the intraoperative and postoperative complications, statistical differences were not observed in the other outcomes between conventional laparoscopic group and robotic Nissen fundoplication group, including total operating interval, effective operating interval, postoperative dysphagia, conversions, re-operation rate, hospital stay and in-hospital costs (P>0.05). It indicates that the robotic Nissen fundoplication is not superior to the traditional laparoscopic surgery in the treatment of gastroesophageal reflux disease. Therefore, we should select the indications careful y.